Factors associated with discontinuation of methadone maintenance therapy (MMT) among persons who also use alcohol in Vancouver, Canada

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Title: Factors associated with discontinuation of methadone maintenance therapy (MMT) among persons who also use alcohol in Vancouver, Canada
Authors: Klimas, Jan
Nosova, Ekaterina
Socías, Eugenia
et al.
Permanent link: http://hdl.handle.net/10197/9943
Date: 1-May-2018
Online since: 2019-04-15T09:21:43Z
Abstract: Background We sought to examine the factors associated with discontinuation of MMT among persons on methadone who use alcohol. Methods We evaluated the impact of drug-related and other factors on discontinuation of MMT among persons enrolled in MMT and who reported any use of alcohol versus those who were enrolled in two community-recruited prospective cohorts of people who use illicit drugs (PWUD). Extended Cox models with time-dependent variables identified factors independently associated with time to first MMT discontinuation. Results Between December 2005 and 2015, 823 individuals on MMT who also reported using alcohol at least once were included in these analyses. During the study period, 391 (47.5%) discontinued methadone. Daily heroin injection (Adjusted Hazard Ratio [AHR] = 2.67, 95% Confidence Interval [CI]: 2.10–3.40) and homelessness (AHR = 1.42, 95% CI: 1.10–1.83) were positively associated with MMT discontinuation, whereas receiving other concurrent addiction treatment in addition to MMT (AHR = 0.07, 95% CI: 0.05–0.08), as well as >60 mg methadone dose (AHR = 0.48, 95% CI: 0.39–0.60), Hepatitis C virus seropositivity (AHR = 0.65, 95% CI: 0.47–0.90), and HIV seropositivity (AHR = 0.72, 95% CI: 0.57–0.91) were negatively associated with MMT discontinuation. Any/heavy alcohol use was not independently associated with MMT discontinuation. Conclusions This study reinforces the known risks of continued heroin injection and homelessness for MMT discontinuation among individuals who also consume alcohol and highlights the protective effect of both MMT dose and receipt of concurrent addiction treatment.
Funding Details: European Commission
Irish Research Council
Type of material: Journal Article
Publisher: Elsevier
Journal: Drug and Alcohol Dependence
Volume: 186
Start page: 182
End page: 186
Copyright (published version): 2018 Elsevier
Keywords: AlcoholMethadoneSubstance-related disordersTreatment outcomes
DOI: 10.1016/j.drugalcdep.2018.01.027
Language: en
Status of Item: Peer reviewed
Appears in Collections:Medicine Research Collection

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